The specific aims of the proposed New Investigator Research Award are: 1) To apply the findings from a series of recently completed studies of the problem-solving strategies of American Indian elderly to the design of a culturally appropriate form of preventive intervention that will increase this special population's ability to cope effectively with the psychosocial stressors that frequently accompany physical-disability and chronic illness; 2) To implement the intervention in two different formats among select groups of American Indian elderly who, on the basis of past work, have been identified as being at high risk of psychological dysfunction and/or severe mental illness as a consequence of physical disability or chronic illness; 3) Using previously developed criterion measures, to evaluate the efficacy of this intervention within a pre-test/post-test control group design to answer a variety of important substantive questions in regard to the nature and extent of cultural accommodation that is required to render the available intervention technology effective with American Indians, and 4) To analyze the cost-effectiveness of the intervention formats taking into account the programmatic meaningfulness of the results, with special attention to the improvement of the procedures to reduce costs and yet maintain preventive benefits. The research proposed herein offers the possibility of discovering new insights into ways of reducing the vulnerability of this and other at-risk, culturally different aged populations to health-related psychological dysfunction or severe mental illness. It represents the logical extension of the applicant's previous work to an area of theoretical, empirical, and pragmatic importance in preventive intervention research.